Background. To assign genetically engineered biologic drugs, we need data on the predictors for response to therapy. Prognostic factors for the response to tocilizumab in patients with juvenile idiopathic arthritis (JIA) without systemic symptoms are poorly studied.Objective. Our aim was to reveal early predictors for the response to tocilizumab therapy in patients with JIA without systemic symptoms.Methods. A retrospective cohort study enrolled patients with JIA without systemic symptoms who received tocilizumab therapy between July 2009 and August 2017. We assessed the association between the initial demographic, clinical, and laboratory parameters in patients and the best response (according to the ACR90 criteria) to treatment after a year.Results. The study included 95 (girls 85%) patients; the mean age was 10.3 (6.0; 13.6). During the first year of therapy, 71 (75%), 55 (58%), 38 (40%), and 22 (23%) patients achieved the improvement according to ACR30/50/70/90 criteria, respectively; 22 (23%) patients reached disease inactive stage according to the Wallace criteria. When performing multivariate analysis, the following improvement predictors were revealed based on the ACR90 criteria after a year of treatment: decrease in serum C-reactive protein level during the first month of therapy [odds ratio (OR) 1.024; 95% confidence interval (CI) 1.007–1.051], decrease in disease activity score on the visual analogue scale according to the parent/patient assessment (OR 1.048; 95% CI 1.005–1.105), early onset of the disease (OR 0.38; 95% CI 0.16–0.72), persistent oligoarthritis according to the ILAR (OR 9.9; 95% CI 1.5–109.3). During the first year of tocilizumab administration, neutropenia was registered in one patient, leukopenia — in three cases, and urticaria — in one case.Conclusion. The variant of JIA, the age at the disease onset, and the disease course pattern in the first month of tocilizumab therapy are the predictors of treatment efficacy throughout the year.

The present review article summarizes the latest world scientific data on the role of receptors for immune mediators in regulating biological effects on the cells. For the main classes of immune regulators (interleukins, interferons, growth factors and tumor necrosis factors), the variants are presented for participation of receptors as components of cytokine/cell interaction, as proven by in vitro and in vivo studies. Ability of the receptors expression to modify characteristics and type of these interactions is shown. The data on participation of receptors for regulatory molecules in development of immune-mediated diseases of various genesis have been analyzed. It was demonstrated that the changes in the receptor expression are of great importance when evaluating functional response of the cells to the mediators and in development of pathological conditions. Current studies confirmed the data suggesting effects of receptor density upon the processes of proliferation and apoptosis, as well as metabolic processes that trigger development of autoimmune, oncological and dystrophic diseases. For all the considered classes of regulatory molecules, the change in the density of receptor expression is one of the key aspects in regulating functional activity of the cells. Thus, studying expression levels of receptors on the cell membrane is important in understanding pathogenesis, whereas changing expression level may be considered as a therapeutic target in the treatment of various diseases.

The objective of the review is to provide multifaceted information on the treatment of young children with severe onset scoliosis using magnetically-controlled growing rods (MCGR). This promising though controversial method is not yet well known in our country. The review presents the history of the development of the method, surgical technique, the frequency of etiological forms of spinal deformities, and describes in detail the results of scoliosis correction including the most severe cases. Quantitative and qualitative data describe complications that arise during the treatment including those characteristic only for this method (for example, slippage phenomena). The problem of repeated operations is separately discussed, and the capabilities of MCGR and other techniques based on the principle of distraction are compared. The review presents features of the use of MCGR in adult patients, the dynamics of the primary curve in the postoperative period (does the Sankar’s law work?), the possibilities of ultrasound when monitoring the effectiveness of magnetic rods, the use of MRI simultaneously with MCGR, and the comparative cost of the method. Particular attention is paid to the problem of a uniform protocol of staged extension of rods. It seems that the initial enthusiasm has somewhat decreased. It is commonly agreed that new research is needed.

Objective. To assess the effect of endocorrector rod fractures on the final result of treatment and the quality of life of patients operated on for spinal deformities of different etiology. Material and Methods. The study included 3833 patients older than 10 years who were operated on for spinal deformities of various etiologies and had not been subjected to spinal surgery before admission to the clinic. In the pre-and postoperative periods, spondylograms in frontal and lateral projections in the standing position were studied using the Cobb method, the apical vertebra rotation was determined in accordance with the method of Sullivan et al. Patients answered questions of the SRS-24 questionnaire in the immediate and long-term follow-up periods. Results. In total, fractures of metal implant rods were detected in 85 (2.2 %) patients. The average scoliotic deformity in these patients was 84.5° before surgery, 49.9° after surgery, and 53.7° at the end of the follow-up period (postoperative progression was 3.8°). Thoracic kyphosis was 61.5° before surgery, 44.3° after surgery, and 48.7° at the end of the follow-up period; lumbar lordosis-68.4°, 54.8°, and 56.5°; and apical vertebra rotation-55.8°, 33.2° and 35.8°, respectively. According to the questionnaire data, patients estimated their appearance after surgery and general appearance somewhat lower and pain as less intense. Indicators of activity and function of the spine after the rod remounting were slightly lower than after the primary surgery. Remounting did not significantly affect the indicator of "consent to surgical treatment under the same conditions"-80.6 and 80.0 %. Цель исследования. Оценка влияния переломов стержней эндокорректора на конечный результат лечения и качество жизни пациентов, оперированных по поводу деформаций позвоночника различной этиологии. Материал и методы. В исследование включены 3833 пациента от 11 до 50 лет, оперированные по поводу деформаций позвоночника различной этиологии, которые не подвергались операциям на позвоночнике до поступления в клинику. В до-и послеоперационном периодах исследовали спондилограммы в прямой и боковой проекциях в положении пациента стоя с использованием метода Cobb, ротацию апикального позвонка определяли по Sullivan et al. В ближайшем и отдаленном послеоперационном периодах пациенты отвечали на вопросы анкеты SRS-24. Результаты. В общей сложности переломы стержней металлоимплантатов были выявлены у 85 (2,2 %) больных. Средняя величина сколиотической деформации у этих пациентов до операции-84,5°, после операции-49,9°, в конце периода наблюдения-53,7°

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